Title 29. Vaccination.pdf ✅

THE PEDIATRICS COURSE c 2020 Prints and More. All rights reserved. PRINTS & MORE ACADEMIC TEAM 29. Vaccinations
1 Vaccines and Vaccination Introduction and Definitions Our ultimate goal from vaccination is eradication and elimination or controlling certain diseases, whereas our immediate goal is the prevention of those diseases. Vaccines are classified either to Active and passive immunization or life-long and partial (waning) immunity. Active immunization: Where we give a part or the whole organism to the patient to induce immune response (humoral or cellular) with no or little risk to the patient. Passive immunization: Where we give the patient preformed antibodies. When a pregnant woman is tested positive for Hepatitis B surface antigen (HBsAG), we give the neonate two injections within 12 hours of delivery; one that contains immunoglobulins on one thigh and Hepatitis B vaccine on the other thigh (passive and active immunization). Life-long immunity: Such as hepatitis A, chickenpox and measles. Partial (waning) immunity: Such as tetanus and measles. We need to give tetanus boosters at regular intervals (10 years) because the immunity to tetanus wanes with time. Here, the doctor only read the 4th column and talked about the importance of vaccines.
2 An example of importance of vaccines is the eradication of smallpox in 1980, which has a case-fatality rate of 30-50% (due to multiorgan failure, coagulopathy, blindness and encephalitis) according to type and age. Last case was recorded in 1978. Types of Vaccines Live attenuated vaccines: Here, we use a weakened (attenuated) form of the germ that causes a disease, so they create a strong immune response. Compared to inactivated vaccines, usually one dose is enough, we also need mucosal protection when given orally. It is contraindicated in pregnancy and immunocompromised patients. BCG, MMR, OPV, rota, varicella, oral typhoid, yellow fever (oral fever and yellow typhoid are given to travellers only) and nasal influenza virus are examples of live attenuated vaccines. OPV is the only vaccine that is contraindicated when a household contains an immunocompromised member. For example, if a child is diagnosed with leukemia and started on chemotherapy then became immunocompromised, none of his family members should receive OPV, they may receive other vaccines but not OPV. Inactivated vaccines: Here, we use the killed version of the germ that causes a disease. They usually don’t provide immunity that is as strong as live vaccines, so we may need several doses over time (booster shots) in order to get ongoing immunity against diseases. DTaP (toxoids and inactivated components), Tdap, Td, DTP, IPV, Hib (polysaccharide conjugate), Hepatitis A (inactivated), Meningococcal, pneumococcal (polysaccharide conjugate or polysaccharide) and Influenza virus (inactivated) are examples of inactivated vaccines. - Note 1: DTaP, Tdap, Td and DTP are the same vaccine but for different age groups. - Note 2: Toxoid vaccines use a toxin made by the germ that causes a disease. They create immunity to the parts of the germ that cause a disease instead of the germ itself. That means the immune response is targeted to the toxin instead of the whole germ.